1. Amber J. Heck, PhD Associate Professor of Biomedical Science
Enhancing Student Mindset and Metacognitive Awareness Through a Hybrid Orientation Program
Amber J. Heck, PhD
Associate Professor of Biomedical Science

2. The Transition into Medical School
Medical students experience isolation, depressive symptoms, anxiety which increase during the first year1-4
Medical schools attempt to address this by offering programs to increase medical student readiness
Interviews/Acceptance
Pre-Admissions
Pre-Matriculation
Matriculation
Orientation

3. What defines readiness?

4. What defines readiness?
Academic preparedness8
Academic “mindset” 9, 10
Self-regulated learning11
Metacognition12
Self-assessment12

5. Research Question
Our previous work has shown that pre-matriculation programs can be employed to impact student growth mindset and metacognitive awareness. 5-7
How can we apply this to all students?

6. Research Question
Can an orientation program be used to impact student readiness related to academic performance and academic mindset?
Specific Aims
Create a hybrid pre-matriculation course and orientation program.
Positively impact learner growth in the following domains: academic mindset, metacognitive awareness, and self-assessment.

7. Methods
Course Design: Format of the SOM curriculum to support self- directed, case-based, and active learning in both large and small groups.
Content: Academic program overview, institutional resources, mindset and professional identity formation, metacognition, and clinical reasoning.
Subjects: First year medical students (n=159)
Data Collection: Pre- and post-implementation instruments: Mindset Assessment Profile (MAP) Tool and Metacognitive Awareness Inventory (MAI).

8. Program Overview

9. Orientation Learner Guide 15

10. Small Group Case-Based Learning
Case-Based Learning (CBL): active discussion on clinical cases specifically constructed to emphasize basic principles16
CBL Orientation Case: Camilla/Aspirin Overdose
Learning Objectives:
1. Describe the process for reporting a medical emergency on the UIWSOM campus.
2. List the situations/scenarios that qualify as misconduct under Title IX.
3. Detail the process for reporting an incident under Title IX.
4. Summarize the UIWSOM policy of social media usage.
5. Describe the FERPA guidelines for releasing academic performance information to a third party.
6. Describe the HIPAA guidelines for releasing personal health information to a third party.
7. Summarize the UIWSOM remediation policy.
8. Detail the process of taking a medical leave of absence.

11. Large Group Sessions Flipped Classroom Model17
Example: Metacognition and Medical Education
Pre-reading:
Livingston, J. Metacognition: An Overview;
Marcum, JA. An integrated model of clinical reasoning: dual-process theory of cognition and metacognition. Journal of Evaluation in Clinical Practice. 18; ; 2012.
Class time:
Academic case vignettes of Marcus, a matriculating medical student

12. Simulated Patient Experience 18
Scored using Interpersonal Skills Evaluation (IPSE) Rubric
Simulated patient (SP) evaluation
Self-evaluation upon leaving the room,
Self-evaluation upon completion of debriefing
After the panel and debriefing, student self- evaluation scores dropped significantly within several IPSE categories
Student evaluation: 68% of respondents (n=41) identifying it as “extremely useful”

13. Results *
*Statistically significant increase in declarative knowledge according to paired T-test (p <0.000)

14. Results
Student evaluation: 93% of respondents (N=45) agreeing that the format of orientation helped prepare them for the SOM curriculum
“The entire structure and format of orientation made the first day of class seem a lot more familiar than it would have otherwise.”
“Orientation helped SO MUCH!!!!! I would be lost right now without that experience.”

15. Conclusions
An active learning approach to academic metacognitive skill training in an orientation program
Self-directed learning, case-based learning, flipped classroom, simulation experience
What can be applied to curriculum design can be applied to co- curriculum design

16. References
Compton MT, Carrera J, Frank E. Stress and depressive symptoms/dysphoria among US medical students: results from a large, nationally representative survey. J Nerv Ment Dis. 2008; 196(12):
Dyrbye, Liselotte N, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Academic Medicine. 2006; 81(4):
Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross-sectional study. Med Educ. 2005; 39:
Paro H, Morales N, de Silva C, Pinto R, Morales R, Mendonca T, et al. Health realted quality of life of medical students. Med Educ. 2010; 44:
Canavan MM, Saavedra R, Russell AY. A health science center's pre-matriculation retreat. Academic Medicine. 1993; 68(5):
Heck AJ. Students Activities in a Pre-matriculation Course as a Predictor of Initial Academic Performance in Medical School. Medical Science Educator.2014; 24:
Heck, AJ, et al. A Survey of the Design of Pre-matriculation Courses at US Medical Schools. Medical Science Educator.2017; 27 (2):
McGaghie, WC. Assessing Readiness for Medical Education Evolution of the Medical College Admission Test. JAMA, 2002; 288(9):
Dweck, C. S. Self-theories: Their role in motivation, personality and development. Philadelphia, PA: Taylor & Francis/Psychology Press; 1999.
Dweck, C. S. Mindset: The new psychology of success. New York, NY: Random; 2006.
Zimmerman, BJ. Becoming a self-regulated learner: An overview. Theory into Practice. 2002; 41(2),
Cao L, and Nietfield, JL. College students’ metacognitive awareness of difficulties in learning the class content does not automatically lead to adjustment of study strategies. Australian Journal of Educational & Developmental Psychology. 2007; 7:31-46.
Heck, A.J. & Underwood, T. A Pre-Matriculation Course that Focuses on a Metacognitive Approach to Learning. Med.Sci.Educ.2016; 26: 515.
Montemayor, J & Heck, AJ. “A Prematriculation Experience to Promote Growth Mindset Formation.”. Poster Presentation, International Association of Medical Science Educators 2017 Meeting.
Elkowitz, D. Socratic Questioning to Engage Learners. In: Fornari, A, and Poznanski, A. How-To Guide for Active Learning. A Publication of the International Association of Medical Science Educators.
Bowe CM, Voss J, Aretz TH: Case method teaching: an effective approach to integrate the basic and clinical sciences in the preclinical medical curriculum, Medical Teacher 31(9):834–841, 2009.
Hugget, K and Jeffries, WB. Overview of Active Learning Research. In: Fornari, A, and Poznanski, A. How-To Guide for Active Learning. A Publication of the International Association of Medical Science Educators.
Heck, AJ, Browne, C, and Solis, L. An Orientation Standardized Patient Experience to Promote Critical Self Reflection American Association of Colleges of Osteopathic Medicine Annual Conference, Oral Presentation.

17. Thank you! Questions? Amber J. Heck, PhD aheck@uiwtx.edu
Kevin E. Kalinowski, PhD
Sophia Pina, PhD